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易患非酒精性脂肪性肝病和2型糖尿病的文化及分子因素。

Cultural and Molecular Factors Predisposed to Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus.

作者信息

George Hanna, Permata Fajar Shodiq, D'Souza Crystal M, Adeghate Ernest A

机构信息

Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates.

Faculty of Veterinary Medicine, Universitas Brawijaya, Malang 65151, Indonesia.

出版信息

Nutrients. 2025 May 26;17(11):1797. doi: 10.3390/nu17111797.

Abstract

There is an exponential increase in the global prevalence of non-alcoholic fatty liver disease (NAFLD) in all populations. The objective of this review is to examine how different cultures and molecular entities influence the progression of NAFLD. Research databases, including PubMed, Scopus, the American Diabetes Association, the American Liver Foundation, and Diabetes UK, were used to retrieve information. Our data analysis showed that cultural norms shape the perceptions of health, illness, and mortality, thus influencing how individuals view themselves and express their experiences and may also affect decisions related to treatment and healthcare. Cultural competence, the ability to understand and navigate cultural differences, is essential for eliciting patient and practitioner perspectives and integrating this understanding into diagnostic and treatment plans. By acknowledging and respecting a patient's cultural background, healthcare providers can foster trust, improve care quality, enhance acceptance of diagnoses, and boost treatment adherence. Although cultural factors play a crucial role in the progression of NAFLD, the disease is also shaped by genetic predispositions, molecular mechanisms, and comorbidities. Molecular pathways involved in the development and progression of NAFLD include alterations in lipid metabolism, insulin signaling, insulin resistance, oxidative stress, defective gut microbiome, and inflammation. This study concludes that a combination of cultural preferences and molecular factors has contributed to the worldwide exponential rise in the prevalence of NAFLD, which in turn has led to an increase in the prevalence of comorbidities such as cardiovascular diseases, diabetes mellitus, and metabolic syndrome.

摘要

在所有人群中,非酒精性脂肪性肝病(NAFLD)的全球患病率呈指数级增长。本综述的目的是研究不同文化和分子因素如何影响NAFLD的进展。我们使用了包括PubMed、Scopus、美国糖尿病协会、美国肝脏基金会和英国糖尿病协会在内的研究数据库来检索信息。我们的数据分析表明,文化规范塑造了人们对健康、疾病和死亡率的认知,从而影响个体如何看待自己、表达自身经历,还可能影响与治疗及医疗保健相关的决策。文化能力,即理解和应对文化差异的能力,对于获取患者和从业者的观点并将这种理解融入诊断和治疗计划至关重要。通过承认和尊重患者的文化背景,医疗服务提供者可以增进信任、提高护理质量、增强对诊断的接受度并提高治疗依从性。尽管文化因素在NAFLD的进展中起着关键作用,但该疾病也受到遗传易感性、分子机制和合并症的影响。参与NAFLD发生和发展的分子途径包括脂质代谢、胰岛素信号传导、胰岛素抵抗、氧化应激、肠道微生物群缺陷和炎症的改变。本研究得出结论,文化偏好和分子因素的共同作用导致了NAFLD全球患病率呈指数级上升,进而导致心血管疾病、糖尿病和代谢综合征等合并症的患病率增加。

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